How Risky Are Abortions, Anyway?

You've probably heard that a Texas law passed in 2013 regarding abortions is currently before the Supreme Court. The lead plaintiff is Whole Woman's Health, a women's clinic in San Antonio, Texas that provides abortions. The law in question contains two provisions that could dramatically affect abortion rights not just in Texas, but across the country. They are:

1. Abortion facilities must meet standards for ambulatory surgical centers, which are like mini-hospitals that have hallways wide enough to fit two gurneys, large operating rooms, more extensive staff, and more.

2. Doctors performing abortions must have admitting privileges at a hospital within 30 miles of the clinic.

Supporters of the law say these provisions protect women's health. The question is: Do they?

The short answer, according to Debra Stulberg, M.D., assistant professor in the Department of Family Medicine at the University of Chicago who performs first-trimester abortions, is no. Worse, the law actually puts women seeking abortions at even greater risk, she says.

For starters, an abortion is an extremely low-risk procedure. There are two ways to terminate a pregnancy: medically or surgically. A medical abortion involves a combination of medications that cause the embryo to detach from the walls of the uterus, and then causes the uterus to contract to terminate the pregnancy. A surgical abortion is a procedure that's done in a doctor's office or clinic and uses suction to terminate the pregnancy. (It's the same procedure that's used when a woman miscarries and her body doesn't get rid of all of the tissue on its own.) Women may have a choice of either method up to 10 weeks gestation; afterward, most abortions are performed using the surgical procedure (which isn't technically surgery–there are no incisions involved and it takes about 10 minutes to do, says Stulberg.) A first-trimester abortion is one of the safest medical procedures-the risk of major complications that might need hospital care is less than 0.05 percent, according to research from the Guttmacher Institute. In fact, the risk of death associated with childbirth is approximately 14 times higher than that with abortion, according to a study in the journal Obstetrics and Gynecology.

So not only does the Texas law not help women, it actually hurts. By decreasing women's access to appropriate care, the law increases wait times and raises costs, says Stulberg. "While abortion is extremely safe within the timeframe during which it's legal to provide them, the risks such as bleeding or damage to the cervix go up as a pregnancy progresses," she says. "If provisions are put in place that close clinics or reduce the number of providers who are available to women, wait times increase."

And forcing clinics to meet the standards for ambulatory surgical centers means many current clinics would need to close, and women would need to travel further to get an abortion. In Texas, the number of licensed abortion facilities decreased from 41 to 18 after the law went into effect. Now, wait times in some cities across the state are now as long as 20 to 23 days, according to a report from the University of Texas. Sadly, a decrease in access to safe abortions may lead more women to use medications, herbs, or household objects to terminate a pregnancy, which can be very dangerous. (

Major medical organizations, including the American Medical Association and the American College of Obstetricians and Gynecologists agree that the provisions in the Texas law don't protect women. If the Supreme Court upholds them, far more women's health will be on the line. "It's a very real possibility that what we said goodbye to when Roe vs. Wade was passed will be back," says Stulberg. (At least some positive progess has been made recently: President Obama just cut abstinence-only sex education from the federal budget.)

While abortions are extremely safe at any approved stage, if you need to have one, the earlier in the pregnancy that it's done, the better. Now if only that were completely in your control...